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Systemic Anti-Cancer Therapy Regimen Library

Home > LEU APL - APML4 induction, consolidation 1 and 2 followed by maintenance [over 70 years] > LEU - APML4 maintenance [over 70 years]
This regimen is a component of LEU APL - APML4 induction, consolidation 1 and 2 followed by maintenance [over 70 years]

APML4 [over 70 years] - Maintenance (LEU APL - APML4 induction, consolidation 1 and 2 followed by maintenance [over 70 years])

Treatment Overview

Starts 3 to 4 weeks after completion of Consolidation 2.

Cycles 1 to 8 - 90 days

Cycle length:
90

tretinoin: Teratogenic—Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.


metHOTREXATe: Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L.


mercaptOPURine:

  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Consider thiopurine methyltransferase (TPMT) testing.

Cycle details

Cycles 1 to 8 - 90 days

Medication Dose Route Days Max Duration
tretinoin 45 mg/m² Daily in divided doses oral administration 1 to 14
metHOTREXATe * 5 mg/m² Once a week oral administration 15, 22, 29,
36, 43, 50,
57, 64, 71,
78, 85
mercaptOPURine 50 mg/m² Once daily oral administration 15 to 90

tretinoin: Teratogenic—Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.


metHOTREXATe: Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L.


mercaptOPURine:

  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Consider thiopurine methyltransferase (TPMT) testing.

Full details

Cycles 1 to 8 - 90 days

Day: 1

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 2

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 3

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 4

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 5

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 6

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 7

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 8

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 9

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 10

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 11

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 12

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 13

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 14

Medication Dose Route Max duration Details
tretinoin 45 mg/m² Daily in divided doses oral administration
Instructions:

Daily in TWO divided doses.

  • Take with food. Swallow whole do not crush or chew.
  • Round dose to closest multiple of 10 mg capsules.
Additional details:

Day: 15

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 16

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 17

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 18

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 19

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 20

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 21

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 22

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 23

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 24

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 25

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 26

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 27

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 28

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 29

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 30

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 31

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 32

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 33

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 34

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 35

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 36

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 37

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 38

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 39

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 40

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 41

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 42

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 43

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 44

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 45

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 46

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 47

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 48

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 49

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 50

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 51

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 52

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 53

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 54

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 55

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 56

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 57

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 58

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 59

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 60

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 61

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 62

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 63

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 64

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 65

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 66

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 67

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 68

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 69

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 70

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 71

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 72

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 73

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 74

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 75

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 76

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 77

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 78

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 79

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 80

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 81

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 82

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 83

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 84

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 85

Medication Dose Route Max duration Details
metHOTREXATe * 5 mg/m² Once a week oral administration
Instructions:
  • Adjust dose (between 5 mg/m2 and 15 mg/m2 ONCE a week) to target neutrophil count of 1 to 2 x 109/L. 
  • Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 86

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 87

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 88

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 89

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Day: 90

Medication Dose Route Max duration Details
mercaptOPURine 50 mg/m² Once daily oral administration
Instructions:
  • Adjust dose (between 50 mg/m2 and 90 mg/m2 ONCE daily) to target neutrophil count of 1 to 2 x 109/L. 
  • Take each dose on an empty stomach – one hour before OR three hours after food or milk.
  • Round dose to closest multiple of 25 mg.
  • Consider thiopurine methyltransferase (TPMT) testing.

Additional details

Section 1: Teratogenic effects

Ensure pregnant women are not exposed to tretinoin. Consult prescribing information.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Minimal to low

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Pharmaco (NZ) Ltd Vesanoid® New Zealand data sheet 21 April 2022 https://www.medsafe.govt.nz/profs/datasheet/v/Vesanoidcap.pdf (accessed 15 July 2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.